Time will tell
In distinction to the United States where women make most of the families’ health care decisions, men govern this decision making in Uganda. Community sensitization about ultrasound is therefore important for both the pregnant women and their husbands. One unanticipated but very welcome anecdotal outcome at Nawanyago Health Centre III (HC) is that men are now coming with their wives to their antenatal visits – early on in our program we elected NOT to give paper print out ultrasound images to the mother at the time of the ultrasound, so their husbands are now coming to the HC to see what’s going on! I am told by everyone in Uganda that this attendance by the husbands is highly unusual. The result of this is that the men are witnessing the ultrasound being performed, asking questions on the spot, and becoming sensitized to ultrasound as a safe diagnostic tool as well as learning about their wife’s pregnancy and any potential issues. Sr. Angela has done a wonderful job of explaining the importance and safety of antenatal ultrasound and has alleviated pre-existing fears about ultrasound causing death of the baby, burns and infertility. This sensitization has likely contributed to the continued success at Nawanyago where each month we are seeing an increase in the number of antenatal visits at the HC by 50% over prior years, as well as a continued 50% increase in the deliveries at the health centre by trained nurse midwives (not at home or with traditional healers). Furthermore, Dr. Alphonsus Matovu, surgeon at Kamuli Mission Hospital (KMH), has reported that 100% of the patients with an ultrasound performed at Nawanyago showing an issue requiring intervention at KMH, the regional referral hospital, have successfully transported to that facility!
Twins were born at Nawanyago HC when I was there. The mom recently had an ultrasound at the HC showing twins with one in a breech position. With this knowledge, she and her husband came together to the HC when she began laboring and the attendants at Nawanyago delivered both babies successfully, one boy and one girl. You can see both proud parents in the photo, holding their hours-old infants – again, it is reported to me that the presence of the father at the HC at the time of delivery or during the first post-partum day is extremely rare! Sr. Angela and her colleagues are elated.
Sr. Angela and I are now wondering whether the attendance of the husbands at the antenatal visits, in this case drawn to the HC by the ultrasound, and apparently defying centuries of tradition, may be as meaningful an outcome as any other - possibly the most important result in that it informs the other life-saving outcomes. We will continue to follow this and perhaps time will tell.